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��y� <br />�1 y <br />9HN <br />4 � <br />K � <br />H 7d <br />�WH <br />� O � <br />OH <br />��g <br />�1] V �] <br />H <br />zyy <br />r i-+ H <br />g �' <br />n d � <br />���i <br />HO[Nn <br />APPLICA71G.d FOR CONSTRUCT�JN PERMIT <br />��«�« <br />1.Op L1e"ti'�v'n <br />GIIY OF � <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PIEASE PRINT <br />259�8810 <br />DEMOLITION COMBINATION BUILDING _ MECHANICAL PLUMBING SIGN <br />ewrven unu nooaess cirv zio �'��n���- <br />� . ,� A �\�uts \91� �„n�t�u�- E„�,.�} y,g�oa -i�ib <br />1ENAM�3 uni�noontss arr ziv� w�orv[ <br />nnCHIT[CIOP�ESIGNER M41tAD�NE55 dTV ZIV PHONE <br />�;Eq[qpLCpNiNPCTOR AIAIIPD�RE55 CITY ].IP PNONE UCENS[• <br />�_�.av.e�i — <br />M[f.HANiCALCOHiPAGiOR MAIL40�RE55 GIiY 21P PNONE LICENSE� <br />m�wviur.fnNiRACiOR MRILRODPE55 CILY ZiP PHONE LICENSEI <br />anss oF wonK <br />NEW � ADDITION ALTERATION �/ REPAIR <br />l l Hnrvi IMPROVEIAENL OR �NLEPIOR REMODCL ONLV <br />° a ��o� <br />CONLRnGTPR�CEOFWORR; � <br />D[SCRiB[ WONn AND SOU�fiE FOOIAGE iNVOLV[D <br />ne \ Ynb:_��_1�e,1�.t_�r--r.. <br />rr�ovosr se ov ew�oi <br />IEGAL O[SLRIPi10�� OF PflOPEPIY ISN01vN OELOW OR ATiACII <br />ior 'J'4 mocrc 3�1.�� oF �� <br />PaOJWi <br />�s <br />TVPE <br />WATER CLOf <br />BATHTUB <br />LAVATORVIV <br />SHOWER <br />8 <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN� <br />ROOF DRAINS—RAi� <br />I � ��. �_ <br />�� 111@lt SEIPACN <br />u5E IONE <br />h i 1 01 COIISL �LIOWRBIE <br />51)E OF B106. <br />OCf,IIPhNGVLOR� <br />H[�iONipR54'iiNNLEPS <br />nrrucnuo���cc ov <br />ITEM <br />DEMOLITION WOODSTOVEiFRPL INSERT . BUILDING RELOCATION <br />CONTRCi P[RSON ANO PNON[ NO. <br />1 HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUL AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINl+NCES GOVERNWCa THIS TYPE OF <br />WOFK WILL BE COMPLETED WITH VJHETHER SPECIFIEO HEREIN OR <br />NOT THE GRANTING Of A PERMIT DOES NOT PRESUIdE TO GIVE <br />AUTHORI7V TO VIOLATE Ofl CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIOtJ OH THE <br />PERFOFMANCE OF CONSTRUCTION. THAT I AM AUThIOFIZ[D BV THE <br />OWNER OF THIS PROPEFTV TO PERfORM TN� WORK FOR WHICH <br />APPI.ICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SICdNiUIiLOFLONTRPGIOROHAU➢IOf.IZ[OAGENi OAiE <br />X �,�..� �. ��� <br />A�P:IGAJ SQIVPUSiHCtivliC[N[ENO A�:; US4[SSNAM[ <br />MECHANICAL <br />NO. TVPE OF EOUIPMENT FEE <br />A C—A HNDLG UNI1S—H.P. _ <br />FORCEDAIR3VS1EId5--BTL. M E.A. <br />UNITHEATEflS—�.7U. M <br />VENTILATION FAN <br />RANG6 FIOOD <br />6YAT[R HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS FIPING <br />FXIiAl1ST FAN <br />SUBTOTAL 5 /1" ,— <br />--r— — <br />PERMIT 5 /� — <br />TOTALFEE 5 C ' <br />REARSElOACN SIpESFiOAGK PIANGe�CCKNOMBER <br />lpipqGp VACANTSiIE FEES <br />YES NO �uauiNG <br />IYPE�iCOHSCALiIIFI �c�i�neqcv NOIXIM1iuMaw�ii — <br />woor pWMBWG <br />NOAiStORiES BRSEMENT MECHANICAL <br />VES NO <br />FIR[SPRNNLERSP[O'0 HEICNTLIMITATION OTHER <br />VES NO STATEBUILDINGSl1RCHARGE <br />STATE EENERGV SUr7CHARGE <br />ainNsnrvnovcnor CITYOFEVERETT runucwoivhs <br />LOCALSALES <br />TAX CODE IS 3'105 rorn� <br />SUB70TAL 5 <br />PERIdIT $ <br />TOTALFEE 5 <br />���� RELEIPiNO <br />1 <br />—�_ . <br />r" • — <br />"'T'1 <br />